10 Phrases That Became Part of the Healthcare Lexicon in 2009

Deeply offended, Rep. Mike Honda, a San Jose Democrat whose district includes Gilroy, promptly delivered Boehner a basket of Gilroy garlic to Boehner's office. He stopped short of trying to send him an actual milkshake or ice-cream, perhaps fearing it would sour or melt along the way.

Honda included a limerick, which his staff presumably wrote:
"Two things make for a strong healthy heart.
Gilroy garlic, for one, a good start.
Public option? Also high in the American eye.
65 percent ne'er want it to part."

6. Guaranteed Issue. Increasingly popular provisions in health reform bills would prohibit health plans from rejecting an applicant based on pre-existing conditions or health risk. The bill approved by both houses of Congress would prevent carriers from setting premiums based on health status.

7. HAIs or Hospital Acquired Infections. Increasingly dreaded by care providers, hospital acquired infections, such as methicillin-resistant staphylococcus aureus or Clostridium difficile, kill 98,000 hospitalized patients. Efforts are underway to use creative efforts, such as hospital observers like secret shoppers, to make sure providers wash their hands whenever they're supposed to and that other universal precautions are taken.

There's more at stake for providers, as Medicare no longer pays for care required because of a HAI, leaving hospitals to absorb the cost of care on their own.

8. Medicare Buy-In. Now, apparently out the window, this health reform proposal would have allowed people between the ages of 55 and 64 to pay premiums in exchange for early eligibility in the Medicare program. Its fading chances are blamed on the fact that it is seen as too expensive, both for government and the would-be enrollee.

9. Nosocomial versus iatrogenic. These labels are frequently used interchangeably, but they too have a subtle difference. Nosocomial incidents originate in a hospital and are usually associated with infections when it's unclear how the incident occurred.

Iatrogenic incidents are the direct result of unintentional actions by a physician or surgeon, such as a sponge left in a surgical cavity or an infection carried by a doctor or nurse who touched two patients without washing.

10. VBP or Value-Based-Purchasing. VBP is a movement by employers and purchasers to get more for their money in improved results. One way to think of VBP is that it might eliminate coverage for procedures for which there is little evidence of efficacy.

According to the Agency for Healthcare Research and Quality, VBP is "any purchasing practices aimed at improving the value of healthcare services, where value is a function of both quality and cost. It can be helpful to think about value as the result of quality divided by cost."